Treatments cut travel to Denver

Two machines at Mercy treat variety of blood-related diseases
SHAUN STANLEY/Durango Herald <br><br>Dr. Darren Schmidt of Mercy Regional Medical Center explains how the hospital's photopheresis machine isolates and removes harmful elements in the bloodstream for treatment of various diseases. The acquisition of the machine save some patients frequent visits to Denver hospitals.

Mercy Regional Medical Center is offering people with certain blood-related ailments treatments that may spare them from traveling to Denver as many as four times a month.

Dr. Darren Schmidt, who arrived at Mercy in August 2009, oversees apheresis and photopheresis treatments. Each procedure involves removing blood from the body for processing. A blood component can be treated and returned to the patient or replaced with a blood product from a donor.

The treatments have been used in only a limited number of patients.

Schmidt earned an undergraduate degree in biochemistry at Louisiana State University, then stayed on to receive his degree in medicine. He did his residency at the University of New Mexico and is a fellow in nephrology at the university's Health Science Center.

The process of bringing the therapies to Mercy must be attributed to more than just him, he said. He cited colleagues Dr. Mark Saddler and Dr. Elizabeth Helms, in addition to Dr. Cynthia Cathcart at Southwest Oncology.

"The nurses who trained to perform the treatments are critical to our success," Schmidt said.

A donation by the Mercy Health Foundation brought a photopheresis machine to the medical center seven or eight months ago, a year after the hospital received its apheresis machine.

Apheresis involves removing whole blood from a patient and passing it through a centrifuge to isolate components and remove an offending element contributing to a disease. The remaining components are retransfused into the patient.

"In certain circumstances," Schmidt said, "specific blood components from a donor are used to replace removed blood products."

The procedure can be a second or third line of treatment for a good number of little known diseases, he said.

Perhaps the best known of the numerous ailments that can be treated through apheresis are Guillain-Barre Syndrome, a disorder affecting the peripheral nervous system, and the exceedingly rare Goodpasture's Syndrome, a group of diseases attacking the kidneys and lungs.

Apheresis also can play a role in fighting certain diseases affecting kidney-transplant patients, Schmidt said; photopheresis is employed to negate or mitigate immune reactions in stem cell or bone marrow transplants.

In the latter cases, the donor cells or marrow see the recipient body as foreign and start an immune reaction. It's opposite to the reaction in a heart or liver transplant in which the patient's body sees the donated organs as intruders.

If photopheresis is used in stem cell or bone marrow surgery, a centrifuge removes white blood cells involved in the immune reaction, bathes the cells with medication, subjects them to ultraviolet light and returns them to the body.

The irradiated cells are less likely to attack the recipient's body, Schmidt said.

A drawback in this procedure is that the patient is extremely sensitive to sunlight after the treatment and must be completely protected from the sun for 24 hours.

His assistants like to relate the case in which a patient whose treatment involved photopheresis arrived in the summer wearing a T-shirt.

When he was to be discharged, the patient had all the requisite protection from the sun - hat, sunglasses, gloves and long pants - except a long-sleeved shirt.

Schmidt stepped forward with his own long-sleeved shirt, which the patient accepted as a loaner for the trip home, two assistants recalled.

"He returned it, washed, the next day," Schmidt said.

daler@durangoerald.com